Management of Upper Tract Urothelial Carcinoma in a Double Collecting System Kidney.

Upper tract urothelial carcinoma (UTUC) in a duplex collecting system (DCS) is a relatively uncommon presentation with unclear management guidelines. Herein, we retrospectively reviewed all published cases of DCS with UTUC aiming to suggest personalized clinical care options for future cases. We conducted a systematic search for all cases of UTUC in DCS from published literature using the following keywords: UTUC, urothelial carcinoma (UC), collecting duct carcinoma, and DCS. The cases were summarized based on demographics, clinical presentation, predisposing risk factors, tumor location, management, and follow-up. We present an additional case based on our experience with a 69-year-old female with high-grade (HG) UTUC of the upper moiety in complete DCS. The patient underwent a robotic upper pole hemi-nephroureterectomy (hemi-NU) with a common sheath distal ureterectomy and a bladder cuff, followed by lower pole ureteral reimplantation. Overall, 34 patients with 35 renal units of UTUC in DCS were included and analyzed. To conclude, UTUC of DCS is rare and underreported. Hence, it is difficult to define a standard treatment. Although hemi-NU has been previously described, to the best of our knowledge, this is the first case report of robot-assisted hemi-NU for complete DCS with single-moiety UC.

Journal of personalized medicine. 2024 Jan 30*** epublish ***

Yarden Zohar, Bezalel Sivan, Ishai Mintz, Ben Hefer, Keren Rouvinov, Noa Shani Shrem, Nicola J Mabjeesh

Department of Urology, Soroka University Medical Center, Faculty of Health Science, Ben-Gurion University of Negev, P.O. Box 151, Be'er Sheva 84101, Israel., The Legacy Heritage Oncology Center, Dr. Larry Norton Institute, Soroka University Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, P.O. Box 151, Be'er Sheva 84101, Israel.